What are we to make of this week's new guidelines about high blood pressure — guidelines that will drag millions of Americans from "borderline" status into full-fledged hypertension?
Here's the key takeaway, we think, for most of the Americans who now meet the criteria for hypertension: You still have the ability to fight the ailment on your terms, but the new standards might prompt you to making some lifestyle changes that you probably already have been pondering.
The new guidelines, formulated by the American Heart Association and the American College of Cardiology, define hypertension as 130/80 millimeters of mercury; the previous guidelines set the threshold for hypertension at 140/90. (The first number, you will recall, is the systolic, which describes the pressure on blood vessels as the heart contracts. The second number, the diastolic, describes the pressure as the heart relaxes.)
The new guidelines essentially increase the number of adults with high blood pressure to 103 million (more than 1 in 3 American adults) from 72 million. (Full disclosure: The author of this editorial, who has had borderline high blood pressure for years, appears to be in full hypertension mode under the new guidelines.)
The new guidelines represent the first major revision of these standards in nearly 15 years. They result from an increasing body of evidence showing that blood pressure lower than what had been considered normal greatly reduces the chances of heart attack and stroke.
The toll of hypertension in the United States remains high: The New York Times reported this week that high blood pressure is second only to smoking as a preventable cause of heart attacks and strokes. And heart disease remains the No. 1 killer of Americans.
Chances are pretty good that you've given up smoking already. So now, if nothing else, these new federal guidelines serve as a reminder that there's no better time than now to focus on lowering your blood pressure.
On one front at least, there is promising news: If you're one of those Americans who requires prescription drugs to keep your blood pressure in check, nearly all of those drugs now are available in generic form, so the cost of prescriptions shouldn't be outrageous.
But experts from the Heart Association and the College of Cardiology said that millions of Americans should be able to meet the goals through changes in lifestyle. In fact, of the additional 31 million Americans targeted by the new criteria, only about 4.2 million will be candidates for drug treatment, the Times reported.
What might that mean for the rest of us? Well, considering that poor diet, lack of exercise and other bad habits cause 90 percent of high blood pressure, the new guidelines offer us an excellent opportunity to make deliberate choices to improve our lifestyles. You need some inspiration to drop that extra 20 pounds? You need a reason to head outside for a brisk walk? These new guidelines might provide just the nudge you need.
Sadly, the new guidelines throw a bit of a damper on some popular approaches to treating blood pressure: For example, there's not enough proof that consuming garlic, dark chocolate, tea or coffee consistently help reduce blood pressure, although certainly no one will fault you for gobbling down some dark chocolate.
In moderation. In moderation.
Of course, you should consult with your doctor before you make dramatic changes in diet or launch a new exercise regimen. And you might want to take the time to use an online calculator (firstname.lastname@example.org) to assess your own risk. (You will need to have some information handy, such as the cholesterol levels in your blood.)
There's no doubt that some people will find these new blood pressure guidelines challenging to meet. But we like the challenge, and the reminder that decisions we make can have a big impact (and a big payoff) for our health. (mm)